Treatments

The purpose if these excercises is to strengthen the pelvic floor muscles that help control urine leakage.  Like any other form of exercise, improvement is a refection of good exercise technique and dedication to doing the exercises regularly.  Your physician can help you identify the right muscles to exercise and give you and exercise schedule.

There are certain dietary elements that can irritate the bladder and aggreviate your bladder symptoms. Your physician will give you a list of certain foods and drinks that you should avoid.

Maintaining healthy body weight is very important for normal pelvic floor function.  As little as a 5% to 10% decrease in weight in women who are overweight or obese will reduce weekly incontinence episodes by more than half.

This means going to the bathroom on a set schedule. The interval between urination is extended every few days as long as leaking accidents are avoided. The goal of this exercise is to regain bladder control by emptying before the sudden strong urge comes.

Medications work by causing relaxation of the bladder wall and prevent abnormal bladder contractions or spasms that can cause symptoms of frequency, urgemcy and urinary leakage before reaching the bathroom. Patients who do need get the desired relief of symptoms with medications or who experience non-tolerable side effects from medications may be candidates from nerve stimulation therapy.

Pessaries are plastic devices, similar to vaginal contraceptive diaphragms, which are used to either lift the bladder. These devices are placed in the vagina to support the vaginal wall and lift up a prolapse.

The treatment consists of intermittent electrical stimulation of the pelvic floor nerve and muscle tissues using a tampon-shaped exerciser inserted into the vagina, or a smaller exerciser inserted into the rectum.

This procedure is also known as tension-free vaginal tape procedure. This is an outpatient, minimally invasive form of sling surgery with a high success rate. The sling is a tape made of a synthetic material. The sling is placed under the urethra, where it acts as a hammock, compressing the urethra to prevent leaks that occur with activities of daily living.

This procedure involves injection of a bulking agent into the area around the bladder neck to tighten it. Bulking materials can be injected into the tissue around the urethra to add bulk and keep the sphincter muscles closed to stop urine from leaking. This procedure can be done in the office.

Repair of a cystocele or “dropped bladder” is a procedure that involves repairing the bladder bulge through the vaginal wall and reinforcing the support between the bladder and vagina. Cystocele is usually corrected through the vagina without abdominal incisions.

Repair of a rectocele or “bulging rectum” is a procedure that involves repairing the rectum bulge through the vaginal wall  and reinforcing the support between the rectum and vagina. Cystocele is usually corrected through the vagina without abdominal incisions.

This procedure involves attaching the top of the vaginal to the ligaments that goes to the sacral (back) bone. This procedure can be done vaginally, laparoscopically or robotically.

This procedure involves attaching the top of the vagina to a strong ligament in the back bone using straps of graft material. This procedure can be done laparoscopically or robotically.

This procedure involves partial or complete closure of the vagina to correct a protruding vaginal bulge. This procedure is reserved for patients who elect not to maintain sexual function.

These defects often occur together high in the vagina, so surgery may be approached through the vagina or abdomen. Treatment options are: uterosacral vaginal vault suspension and sacral colpopexy.

This type of treatment involves putting a very small needle (similar to an acupuncture needle) close to the tibial nerve (above the ankle joint) and stimulating the nerve with gentle electrical impulses. The treatment session is 30 minutes. Multiple treatment sessions are needed to achieve the treatment goal. This is a very simple type of treatment that is done in the office.

This is a minor outpatient procedure that involved placing a lead (wire) close to the back bone. This wire will be connected to a stimulation device to gently stimulate the sacral nerves that go to your bladder. Initially the stimulator will be outside your body and you can wear it around your waist (like a cell phone or a pager). If significant improvement of your bladder symptoms is seen a stimulator can be implanted under your skin like a pace maker instead of the external stimulator.